山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (1): 95-99.doi: 10.6040/j.issn.1673-3770.0.2016.203

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重组人表皮生长因子预防鼻咽癌放射性口腔黏膜炎和急性放射性皮炎的疗效观察

于斌,郑青平,罗展雄,李旌,周媛媛,李中华,王磊黎,贺婵娟,石丰榕   

  1. 广西柳州市人民医院肿瘤放疗科, 广西 柳州 545006
  • 收稿日期:2016-05-09 出版日期:2017-02-16 发布日期:2017-02-16
  • 通讯作者: 郑青平

Efficacy of recombinant human epidermal growth factor in prevention of radioactive oral mucosa inflammation and acute radiation dermatitis for nasopharyngeal carcinoma.

  1. Department of Radiation Oncology, Liuzhou Peoples Hospital, Liuzhou 545006, Guangxi, China
  • Received:2016-05-09 Online:2017-02-16 Published:2017-02-16

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摘要： 目的 观察重组人表皮生长因子(rhEGF)预防鼻咽癌(NPC)放射性口腔黏膜炎和急性放射性皮炎的临床疗效。 方法 将2014年1月至2015年12月收治的50例鼻咽癌患者(Ⅱ期5例,Ⅲ期32例,Ⅳa期13例)随机分为试验组(n=26)和对照组(n=24),两组全程均给予调强放射治疗,放疗周期6周,对照组同时采用顺铂单药化疗,每7 d为一周期,化疗周期为5~6周期;试验组在对照组的治疗基础上同期联合重组人表皮生长因子(口腔喷雾和颈部皮肤涂抹凝胶)进行治疗。以完全缓解、部分缓解、疾病稳定和疾病进展评价两组近期疗效,并采用美国国立癌症研究所常规毒性判定标准对不良反应进行评定。 结果 两组近期疗效基本相当(P>0.05);两组未出现因不良反应致死的情况;两组患者在治疗过程中出现的不良反应率基本相当,均以消化道毒性、骨髓抑制、肝功异常为主;两组患者均发生Ⅰ级以上的放射性口腔黏膜炎和颈部急性放射性皮炎,试验组中Ⅱ级以上放射性口腔黏膜炎和急性放射性皮炎的发生率(42.31%和11.54%)均明显低于对照组(70.83%和41.67%),差异均有统计学意义(P=0.042,0.035)。 结论 重组人表皮生长因子同期联合放化疗治疗鼻咽癌可以有效降低放化疗所致的放射性口腔黏膜炎和颈部急性放射性皮炎等不良反应的发生率。

关键词: 重组人表皮生长因子, 放射性口腔黏膜炎, 颈部急性放射性皮炎, 鼻咽癌

Abstract: Objective To observe the efficacy of recombinant human epidermal growth factor(rhEGF)in prevention of radioactive oral mucosa inflammation and acute radiation dermatitis of nasopharyngeal carcinoma(NPC). Methods A total of 50 NPC patients(5 stage Ⅱ, 32 stageⅢ and 13 stage Ⅳa)in the department of radiation oncology of our hospital hospitalized from January 2014 to December 2015 were randomly divided into the experimental group(n=26)and the control group(n=24).The two groups were treated with intensity modulated radiation therapy on the whole course, 6 weeks a radiotherapy cycle. The control group was given cisplatin single agent chemotherapy, and every 7 days for a cycle, 5 to 6 cycles. On the basis of the treatment of the control group, the experimental group was treated with combination of rhEGF(oral spray and neck skin smear gel)in the same period of the treatment. Short-term efficacy of the two groups was evaluated with complete remission, partial remission, stable disease and progression disease. The toxicity and side-effects were evaluated by the National Cancer Institute Common Toxicity Criteria(NCI-CTC). Results The short-term efficacy of the two groups was basically equivalent(P>0.05). No patients died in the two groups due to the toxic side effects, and the main toxicities in the two groups were gastrointestinal toxicity, myelosuppression and abnormal liver function. All patients had happened radioactive oral mucosa inflammation and acute radiation dermatitis of the neck which level was over grade Ⅰ. The incidence of radioactive oral mucosa inflammation and acute radiation dermatitis of the neck over grade Ⅱ level in the experimental group(42.31% and 11.54%)were significantly lower than those of the control group(70.83% and 41.67%)(P=0.042, 0.035). Conclusion The method of combination radiotherapy and chemotherapy with rhEGF in the treatment of NPC can effectively reduce the incidence of 山东大学耳鼻喉眼学报31卷1期 -于斌,等.重组人表皮生长因子预防鼻咽癌放射性口腔黏膜炎和急性放射性皮炎的疗效观察 \=-toxicity and side-effects of radioactive oral mucosa inflammation and acute radiation dermatitis of neck which caused by radiotherapy and chemotherapy.

Key words: Recombinanthuman epidermal growth factor, Radioactive oral mucosa inflammation, Nasopharyngeal carcinoma, Acute radiation dermatitis of the neck

中图分类号: 

  • R739.63
[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016[J]. CA Cancer J Clin, 2016, 66(1):7-30.
[2] 司勇锋,陶仲强.鼻咽癌病因学和防治研究[J].中国耳鼻咽喉头颈外科,2010,17(3):163-165.
[3] Cao SM, Liu ZW, Jia WH, et al. Fluctuations of epstein-barr virus serological antibodies and risk for nasopharyngeal carcinoma: a prospective screening study with a 20-year follow-up[J]. PLoS One, 2011, 6(4):e19100.
[4] Cao SM, Simons MJ, Qian CN. The prevalence and prevention of nasopharyngeal carcinoma in China[J]. Chin J Cancer, 2011, 30(2):114-119.
[5] 黄启洪,李艳华.四会市1978-2007年鼻咽癌发病趋势分析[J].中国肿瘤,2011,20(8):571-572. HUANG Qihong, LI Yanhua. An Analysis of Trend for Nasopharyngeal Carcinoma Incidence from 1978 to 2007 in Sihui City, Guangdong Province[J]. Chin Cancer, 2011, 20(8):571-572.
[6] 黄祥,曲超,姜新,等.鼻咽癌的治疗进展[J].中国老年学杂志,2015,35(11):3159-3161.
[7] Guigay J. Advances in nasopharyngeal carcinoma[J]. Curr Opin Oncol, 2008, 20(3):264-269.
[8] 钟海林, 陈国谋, 林丹平,等.69例鼻咽癌常规放疗与调强放疗的不良反应比较[J].临床耳鼻咽喉头颈外科杂志,2013,27(9):462-464. ZHONG Hailin, CHEN Guomou, LIN Danping, et al. Comparison of side effects of intensity modulated radiotherapy and conventional radiotherapy in 69cases with nasopharyngeal carcinoma[J]. Clin Otolaryngol Head Neck Surgery, 2013, 27(9):462-464.
[9] 蒋靖, 夏立君.他克莫司软膏联合重组人表皮生长因子凝胶治疗面部激素依赖性皮炎39例[J].中国皮肤性病学杂志, 2012, 26(6):506-508. JIANG Jing, XIA Lijun. Thirty-nine cases of hormone-dependent facial dermatitis treated with tacrolimus ointment and recombinant human epidermal growth factor gel[J]. Chin J Dermatovenereol, 2012, 26(6):506-508.
[10] 中国鼻咽癌临床分期工作委员会.鼻咽癌'92分期修订工作报告[J].中华放射肿瘤学杂志,2009,18(1):2-5.
[11] Schwartz LH, Bogaerts J, Ford R, et al. Evaluation of lymph nodes with RECIST 1.1.[J]. Eur J Cancer, 2009, 45(2):261-267.
[12] 傅志超,程惠华,李东石,等.鼻咽癌强调放疗联合尼妥珠单抗加同期顺铂化疗的临床观察[J].中国肿瘤防治杂志, 2011,18(18):1475-1477.
[13] 张典刚, 黄莉, 耿晓涛, 等. 局部晚期鼻咽癌强调放疗远期疗效分析[J]. 新疆医科大学学报, 2015, 38(1):17-20, 25. ZHANG Diangang, HUANG Li, GENG Xiaotao, et al. Long-term results in locally advanced nasopharyngeal carcinoma treated by intensity-modulated radiotherapy[J]. J Xinjiang Med Univ, 2015, 38(1):17-20, 25.
[14] ICRU report 50: Prescribing, recording, and reporting photon beam therapy[S]. Bethesda, MD: International Commission on Radiation Units and Measurem ents, 1993.
[15] ICRU report 62: Prescribing, recording, and reporting photon beam therapy(supplement to ICRU Report 50)[S]. Bethesda, MD: International Commission on Radiation Units and Measurem ents, 1999.
[16] 王跃建,邓燕明,虞幼军,等.鼻咽癌诊断和治疗[M].北京:人民卫生出版社, 2013:440.
[17] Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group(RTOG)and the European Organization for Research and Treatment of Cancer(EORTC)[J]. Int J Radiat Oncol Biol Phys, 1995, 31(5):1341-1346.
[18] 杜立法,王俊杰.放疗杀伤肿瘤细胞机制的研究进展[J].癌症进展,2014,12(4):341-345.
[19] 戴如立,林广明,骆映峰,等.重组人表皮细胞生长因子治疗急性放射性皮肤溃疡的临床观察[J].中国现代药物应用,2010,4(16):59-60.
[20] 刘尚贤,张春. 重组人表皮细胞生长因子在鼻咽癌放疗中预防放射性口咽炎疗效观察[J].中国医药科学,2014,4(20):168-169,172.
[21] 龚倩,谌赟,符一岚,等. 重组人表皮细胞生长因子联合氨磷汀治疗鼻咽癌患者放射性口腔黏膜炎的临床观察[J].中国药房,2015,26(14):1971-1973.
[22] Miyazaki M, Mars WM, Runge D, et al. Phenobarbital suppresses growth and accelerates restoration of differentiation markers of primary culture rat hepatocytes in the chemically defined hepatocyte growth medium containing hepatocyte growth factor and epidermal growth factor[J]. Exp Cell Resh, 1998, 241(2):445-457.
[23] Hong JP, Lee SW, Song SY, et al. Recombinant human epidermal growth factor treatment of radiation-induced severe oral mucositis in patients with head and neck malignancies[J]. Eur J Cancer Care(Engl), 2009, 18(6):636-641.
[24] Hong JP, Jung HD, Kim YW. Recombinant human epidermal growth factor(EGF)to enhance healing for diabetic foot ulcers[J]. Ann Plast Surg, 2006, 56(4):394-398; discussion 399-400.
[25] 吴宏,李燕,陈洁.重组人表皮生长因子凝胶与硝酸银软膏联合治疗放射性皮肤损伤[J].现代中西医结合杂志,2011,21(15):1678-1679.
[26] 郭杏,谭美云,郭力,等.重组人表皮细胞生长因子对供皮区创面的修复[J].中国组织工程研究,2010,14(5):862-865.
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